摘要
目的 分析高分辨率T2加权成像(HR-T2WI)联合对比增强磁共振成像(DCE-MRI)、扩散加权成像(DWI)评估直肠癌术前分期及环周切缘(CRM)的价值。方法 选取医院2019年4月至2024年6月期间收治的102例直肠癌患者为研究对象,患者术前均行HR-T2WI、DCE-MRI及DWI检查,术后均行病理活检,以术后病理学检查为“金标准”,分析HR-T2WI联合DCE-MRI、DWI对直肠癌术前分期及CRM的评估价值。结果 102例直肠癌患者经手术病理检查证实,T1期15例、T2期23例、T3期25例、T4期39例;N0期35例、N1期42例、N2期25例;CRM阳性48例、阴性54例。HR-T2WI、DCE-MRI、DWI及三者联合评估术前T分期的准确率分别为74.51%(76/102)、78.43%(80/102)、82.35%(84/102)、92.16%(94/102),三者联合评估术前T分期的准确率显著高于HR-T2WI、DCE-MRI、DWI单独评估,且差异有统计学意义(χ^(2)=11.819,P<0.05)。HR-T2WI、DCE-MRI、DWI及三者联合评估术前N分期的准确率分别为75.49%(77/102)、7 7.4 5%(7 9/1 0 2)、85.29%(87/102)、92.16%(94/102),三者联合评估术前N分期的准确率显著高于HR-T2WI、DCE-MRI、DWI单独评估,且差异有统计学意义(χ^(2)=12.465,P<0.05)。三者联合评估术前CRM的灵敏度、特异度及准确率分别为89.58%、94.44%、92.16%,特异度及准确率显著高于HR-T2WI、DCE-MRI、DWI单独评估,且差异有统计学意义(χ^(2)=8.831、13.736,P<0.05)。结论 HR-T2WI联合DCE-MRI、DWI可提高对直肠癌术前分期及CRM的评估价值。
Objective To analyze the value of high-resolution T2-weighted imaging(HR-T2WI)combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)and diffusion-weighted imaging(DWI)in evaluating preoperative staging and circumferential resection margin(CRM)in rectal cancer.Methods A total of 102 patients with rectal cancer admitted to the hospital from April 2019 to June 2024 were selected as the research subjects.All patients underwent HR-T2WI,DCE-MRI and DWI examinations before surgery,and pathological biopsy after surgery.Postoperative pathological examination was used as the gold standard to analyze the value of HR-T2WI combined with DCE-MRI and DWI in evaluating preoperative staging and CRM in rectal cancer.Results Surgical and pathological results showed 15 cases in T1 stage,23 cases in T2 stage,25 cases in T3 stage and 39 cases in T4 stage,35 cases in N0 stage,42 cases in N1 stage and 25 cases in N2 stage,48 cases positive for CRM and 54 cases negative for CRM.The accuracy rates of HR-T2WI,DCE-MRI,DWI,and their combination for evaluating preoperative T staging were 74.51%(76/102),78.43%(80/102),82.35%(84/102),and 92.16%(94/102),respectively.The accuracy rate of joint evaluation was significantly higher than that of separate evaluation(χ^(2)=11.819,P<0.05).The accuracy rates of HR-T2WI,DCE-MRI,DWI,and their combination for evaluating preoperative N staging were 75.49%(77/102),77.45%(79/102),85.29%(87/102),and 92.16%(94/102),respectively.The accuracy of joint evaluation was significantly higher than that of separate evaluation(χ^(2)=12.465,P<0.05).The sensitivity,specificity and accuracy of combination of the three for evaluating preoperative CRM were 89.58%,94.44%,and 92.16%,respectively.The specificity and accuracy were significantly higher than those of separate evaluation(χ^(2)=8.831,13.736,P<0.05).Conclusion HR-T2WI combined with DCE-MRI and DWI can improve the evaluation of preoperative staging and CRM in rectal cancer.
作者
张馨允
杨志忠
任建伟
郭子豪
孙兴红
ZHANG Xin-yun;YANG Zhi-zhong;REN Jian-wei;GUO Zi-hao;SUN Xing-hong(Department of General Surgery I,The Third People's Hospital of Henan Province,Zhengzhou 450006,Henan Province,China)
出处
《中国CT和MRI杂志》
2025年第12期161-163,共3页
Chinese Journal of CT and MRI
关键词
直肠癌
术前分期
环周切缘
高分辨率T2加权成像
对比增强磁共振成像
扩散加权成像
Rectal Cancer
Preoperative Staging
Circumferential Resection Margin
High-resolution T2-Weighted Imaging
Dynamic Contrast-enhanced Magnetic Resonance Imaging
Diffusion-Weighted Imaging
